Provider Demographics
NPI:1780780841
Name:RODRIGUEZ, ISABEL (MD)
Entity type:Individual
Prefix:
First Name:ISABEL
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 NW 43RD ST STE D2
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-8127
Mailing Address - Country:US
Mailing Address - Phone:352-872-5755
Mailing Address - Fax:352-872-5102
Practice Address - Street 1:3600 NW 43RD ST STE D2
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-8127
Practice Address - Country:US
Practice Address - Phone:352-872-5755
Practice Address - Fax:352-872-5102
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16599208D00000X
FLACN441208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL008968700Medicaid
FLHI757YMedicare PIN